Journal List > J Korean Soc Spine Surg > v.21(1) > 1076041

J Korean Soc Spine Surg. 2014 Mar;21(1):36-40. Korean.
Published online March 31, 2014.
© Copyright 2014 Korean Society of Spine Surgery
Digital Pulse Oximetry for the Screeing of Lower Extremity Arterial Disease
Dae Moo Shim, M.D., Sung Kyun Oh, M.D., and Jung Nam Kwon, M.D.*
Department of Orthopedic Surgery,School of Medicine, Wonkwang University, Iksan, Korea.
*Division of Vascular Surgery, School of Medicine, Wonwang University, Gunpo, Korea.
Institute of Wonkwang Medical Science. Iksan, Korea.

Corresponding author: Sung Kyun Oh, M.D. Department of Orthopedic Surgery, School of Medicine, Wonkwang University Sanbon Hospital, Sanbon-dong, Gunpo city, Gyeongi-do, Korea. TEL: 82-31-390-2992, FAX: 82-31-390-2244, Email:
Received January 15, 2013; Revised February 26, 2013; Accepted November 28, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Study Design

Retrospective study.


The aim of the study was to investigate the usefulness of a handheld digital pulse oximetry in the detection of lower extremity arterial disease.

Summary of Literature Review

Pulse oximetry is a well-established method for noninvasive evaluation of arterial oxygenation.

Materials and Methods

A Retrospective study was performed in 45 patients with lower extremity arterial disease. We compared the accuracy of a handheld digital pulse oximetry and the ankle brachial index (ABI). Digital pulse oximetry was conducted for 42 patients with 84 limbs to measure the SaO2 of their index fingers and big toes in supine position. The ABI was defined as abnormal if it was less than 0.9. Pulse oximetry of big toes was defined as abnormal if the SPO2 was less than 96% or it was more than 2% lower than that of the index finger.


Digital pulse oximetry had a sensitivity of 47%(95% CI, 34-60%) and specificity of 86%(95% CI, 64-96%). ABI had a sensitivity of 49%(95% CI, 34-64%) and specificity of 95%(95% CI, 72-99%). Positive predictive values were 91%(95% CI, 74-98%) for digital pulse oximetry and 96%(95% CI, 77-99%) for ABI. Negative predictive values were 37%(95% CI, 24-51%) for digitial pulse oximetry and 43%(95% CI, 25-72%) for ABI. In 22 cases with acute ischemicwere the sensitivity 73%, the specifity 100%, the positive predictive value 100% and the negative predictive value 79%.


Handheld digital pulse oximetry of the big toes seems as accurate as ABI to detect lower extremity arterial diseases. The combination of both will help to distinguish low extremity arterial disease and spinal radiculopathy.

Keywords: arterial disease; pulse oximetry; ankle brachial index


Fig. 1
Handheld digital pulse oximetry.
Click for larger image

Fig. 2
Receiver operating characteristic (ROC) curve for the pulse oximetry test and the ankle brachilaindex(ABI). (A) ROC curve for pulse oximetry test, Area under the curve was 0.321 (95% confidence interval:0.205-0.438,p<0.014). (B) ROC curve for ABI, Area under the curve was 0.375 (95% confidence interval:0.246-0.505,p<0.114).
Click for larger image


Table 1
Demography of patients.
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Table 2
Results for Pulse oximetry test, Ankle brachial index.
Click for larger image


This paper was supported by Wonkwang univeristy in 2014.

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